The prostate remains the second most common cause of cancer death. Because the incidence of prostate cancer increases more rapidly with age than does any other cancer and because the life expectancy is increasing, the number of men with prostate cancer and the number of deaths from the disease are expected to rise. Most prostate cancers detected nowadays are clinically localized and likely to be cured. A major treatment alternative for these patients includes radical prostatectomy, which is the complete surgical removal of the prostate gland along with its fascial coverings, requiring disconnecting the prostate from the urethra at the urogenital diaphragm and the urinary bladder at the bladder neck. To restore continuity of the urinary tract where the prostate has been removed, a new connection (anastomosis) of the bladder neck to the urethra must be accomplished. It is the attachment of the urethral stump to the bladder neck which is particularly difficult. This difficulty arises from several aspects including the tendency of the urethral stump to retract into adjacent tissue as well as its delicate structure mandating placement of thin and accurate sutures to ascertain that sufficient urethral tissue is incorporated into the anastomosis without damaging the sphincteric mechanism. Further complicating this procedure is the fact that the urethral stump is located beneath the pubic bone thus requiring that the surgeon work at a difficult angle and in positions that are uncomfortable and limiting.
A major impediment of radical prostatectomy remains its postoperative sequel related to the urethro-vesical anastomosis, which if not properly performed can lead to both urinary incontinence and outflow obstruction secondary to stricture at the anastomosis site.
Thus there remains a long felt need for the present invention relating to the reconnection of the urethra and bladder after a radical retropubic prostatectomy, specifically a method and device for performing a urethral-vesicle anastomosis.